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Psychodynamic group psychotherapy: impact of group length and therapist professional characteristics on development of therapeutic alliance.

https://arctichealth.org/en/permalink/ahliterature134066
Source
Clin Psychol Psychother. 2012 Sep;19(5):420-33
Publication Type
Article
Date
Sep-2012
Author
Steinar Lorentzen
Jan Vegard Bakali
Anne Grete Hersoug
Knut A Hagtvet
Torleif Ruud
Per Høglend
Author Affiliation
Institute of Clinical Medicine, University of Oslo, Oslo, Norway. steinar.lorentzen@medisin.uio.no
Source
Clin Psychol Psychother. 2012 Sep;19(5):420-33
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adult
Factor Analysis, Statistical
Female
Humans
Linear Models
Male
Middle Aged
Models, Psychological
Norway
Professional-Patient Relations
Psychotherapeutic Processes
Psychotherapy - education - methods
Psychotherapy, Group - methods
Sociometric Techniques
Time Factors
Abstract
Little research has been done on therapeutic alliance in group psychotherapy, especially the impact of treatment duration and therapist professional characteristics.
Therapeutic alliance was rated by patients on the Working Alliance Inventory-Short Form at three time points (sessions 3, 10 and 17) in a randomized controlled trial of short-term and long-term psychodynamic group psychotherapy. As predictors we selected therapist clinical experience and length of didactic training, which have demonstrated ambiguous results in previous research. Linear latent variable growth curve models (structural equation modeling) were developed for the three Working Alliance Inventory-Short Form subscales bond, task and goal.
We found a significant variance in individual growth curves (intercepts and slopes) but no differential development due to group length. Longer therapist formal training had a negative impact on early values of subscale task in both treatments. There was an interaction between length of the therapists' clinical experience and group length on early bond, task and goal: therapists with longer clinical experience were rated lower on initial bond in the long-term group but less so in the short-term group. Longer clinical experience influenced initial task and goal positively in the short-term group but was unimportant for task or significantly negative for goal in the long-term group.
There was no mean development of alliance, and group length did not differentially impact the alliance during 6 months. Early ratings of the three Working Alliance Inventory-Short Form subscales partly reflected different preparations of patients in the two group formats, partly therapist characteristics, but more research is needed to see how these aspects impact alliance development and outcome. Therapists should pay attention to all three aspects of the alliance, when they prepare patients for group therapy.
In psychodynamic groups, length of therapy does not differentiate the overall level or the development of member-leader alliance. Within psychodynamic groups, each individual appear to have their unique perception of the member-leader alliance. Therapists with longer formal psychotherapy training may be less successful in establishing early agreement with patients on the tasks of psychodynamic group psychotherapy. Patients perceive a somewhat lower degree of early emotional bonding with the more clinically experienced therapists in long-term psychodynamics groups. Therapists with more clinical experience may contribute to a stronger degree of initial agreement with patients on the tasks and goals of short-term group psychotherapy.
PubMed ID
21626613 View in PubMed
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Guidelines for the psychotherapies in comprehensive psychiatric care: a discussion paper. Working Group 2 of the Canadian Psychiatric Association Psychotherapies Steering Committee.

https://arctichealth.org/en/permalink/ahliterature201653
Source
Can J Psychiatry. 1999 Jun;44 Suppl 1:4S-17S
Publication Type
Article
Date
Jun-1999
Author
K R MacKenzie
M. Leszcz
A. Abbass
Y. Hollander
I. Kleinman
J. Livesley
G. Pinard
M V Seeman
Author Affiliation
Department of Psychiatry, University of British Columbia, Vancouver. rmack@interchange.ubc.ca
Source
Can J Psychiatry. 1999 Jun;44 Suppl 1:4S-17S
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Canada
Documentation
Humans
Mental Health Services - standards
Professional-Patient Relations
Psychiatry - standards
Psychotherapy - standards
PubMed ID
10390651 View in PubMed
Less detail

Therapists' professional and personal characteristics as predictors of working alliance in short-term and long-term psychotherapies.

https://arctichealth.org/en/permalink/ahliterature265503
Source
Clin Psychol Psychother. 2014 Nov-Dec;21(6):475-94
Publication Type
Article
Author
Erkki Heinonen
Olavi Lindfors
Tommi Härkänen
Esa Virtala
Tuija Jääskeläinen
Paul Knekt
Source
Clin Psychol Psychother. 2014 Nov-Dec;21(6):475-94
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - therapy
Clinical Competence - statistics & numerical data
Cooperative Behavior
Depressive Disorder - therapy
Female
Finland
Follow-Up Studies
Health Personnel - psychology
Humans
Male
Mental Disorders - therapy
Middle Aged
Personality
Professional-Patient Relations
Psychotherapy - methods
Psychotherapy, Brief - methods
Questionnaires
Young Adult
Abstract
To investigate the determinants of the therapeutic working relationship and better understand its intrapersonal and interpersonal nature, this study investigated therapist characteristics as predictors of the formation and development of patient-rated and therapist-rated working alliances within a clinical trial of short-term versus long-term therapies. Short-term (solution-focused and short-term psychodynamic) and long-term (long-term psychodynamic therapy and psychoanalysis) therapies were provided by 70 volunteering, experienced therapists to 333 patients suffering from depressive and/or anxiety disorders. Therapists' professional and personal characteristics, measured prior to the start of the treatments, were assessed with the comprehensive self-report instrument, Development of Psychotherapists Common Core Questionnaire. The Working Alliance Inventory was rated by both therapists and patients at the third session and at the 7?months' follow-up point from the initiation of therapy. Therapists' self-rated basic interpersonal skills were found to predict the formation of better patient-rated alliances in both short-term and long-term therapies. Engaging, encouraging relational style fostered improvement of patients' working alliances especially in the course of short-term therapies. However, it led to patient alliance deterioration in long-term therapies, where constructive coping techniques proved more beneficial. Therapists' professional self-confidence and work enjoyment, along with their self-experiences in personal life, consistently predicted their alliances, but were less salient for patient ratings of alliance. The divergence of therapist and patient viewpoints has implications for therapist training and supervision, as characteristics found detrimental or helpful for the working relationship rated from the perspective of one party may not be predictive of the other therapy participant's experience.
PubMed ID
23813617 View in PubMed
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[Research of effectiveness is a challenge in psychotherapy].

https://arctichealth.org/en/permalink/ahliterature176584
Source
Duodecim. 2004;120(22):2645-53
Publication Type
Article
Date
2004
Author
Mikael Leiman
Author Affiliation
Joensuun yliopisto, psykologan laitos. mikael.leiman@joensuu.fi
Source
Duodecim. 2004;120(22):2645-53
Date
2004
Language
Finnish
Publication Type
Article
Keywords
Female
Finland
Humans
Male
Professional-Patient Relations
Prognosis
Psychotherapy - methods
Research - standards - trends
Risk factors
Treatment Outcome
Truth Disclosure
PubMed ID
15656421 View in PubMed
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Constructing and negotiating 'change' in follow-up meetings for intimately violent men.

https://arctichealth.org/en/permalink/ahliterature146403
Source
Commun Med. 2010;7(1):65-74
Publication Type
Article
Date
2010
Author
Terhi Partanen
Jarl Wahlström
Juha Holma
Author Affiliation
Psychiatric Outpatient Services, Tampere, Finland. terhi.partanen@tampere.fi
Source
Commun Med. 2010;7(1):65-74
Date
2010
Language
English
Publication Type
Article
Keywords
Finland
Follow-Up Studies
Humans
Male
Narration
Negotiating
Professional-Patient Relations
Psycholinguistics
Psychotherapeutic Processes
Psychotherapy, Group
Sociometric Techniques
Violence - psychology
Abstract
This study reports on follow-up meetings of a group treatment program for intimately violent men. The focus is on the construction of change narratives; on how indicators of 'successful change' are negotiated and produced in the conversations. We describe in detail five discursive strategies used by client and therapist participants, e.g., the construction of temporal differences, personalizing the problem, reformulations of failure stories, taking presence at the follow-up as evidence of success, and the use of out-siders as an audience. We also demonstrate how the notion of success is ascertained and to whom credit is given for achieving it. We conclude that the followup meetings are established as an integrated part of the whole treatment program, and contribute to the promotion of the treatment ideology.
PubMed ID
21462858 View in PubMed
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Does the working alliance mediate the effect of routine outcome monitoring (ROM) and alliance feedback on psychotherapy outcomes? A secondary analysis from a randomized clinical trial.

https://arctichealth.org/en/permalink/ahliterature299441
Source
J Couns Psychol. 2019 Mar; 66(2):234-246
Publication Type
Journal Article
Randomized Controlled Trial
Date
Mar-2019
Author
Heidi Brattland
John Morten Koksvik
Olav Burkeland
Christian A Klöckner
Mariela Loreto Lara-Cabrera
Scott D Miller
Bruce Wampold
Truls Ryum
Valentina Cabral Iversen
Author Affiliation
Department of Mental Health.
Source
J Couns Psychol. 2019 Mar; 66(2):234-246
Date
Mar-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Adult
Feedback, Psychological
Female
Health Personnel - standards - trends
Humans
Male
Norway - epidemiology
Professional-Patient Relations
Psychotherapy - standards - trends
Treatment Outcome
Abstract
Little is known about the mechanisms through which routine outcome monitoring (ROM) influences psychotherapy outcomes. In this secondary analysis of data from a randomized clinical trial (Brattland et al., 2018), we investigated whether the working alliance mediated the effect of the Partners for Change Outcome Monitoring System (PCOMS), a ROM system that provides session-by-session feedback on clients' well-being and the alliance. Adult individuals (N = 170) referred for hospital-based outpatient mental health treatment were randomized to individual psychotherapy either with the PCOMS ROM system, or without (treatment as usual [TAU]). Treatment was provided by the same therapists (N = 20) in both conditions. A multilevel mediation model was developed to test if there was a significant indirect effect of ROM on client impairment at posttreatment through the alliance at 2 months' treatment controlled for first-session alliance. Alliance ratings increased more from session 1 to 2 months' treatment in the ROM than TAU condition, and alliance increase was associated with less posttreatment impairment. A significant indirect effect of ROM on treatment outcomes through alliance increase (p = .043) explained an estimated 23.0% of the effect of ROM on outcomes. The results were consistent with a theory of the alliance as one mechanism through which ROM works. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
PubMed ID
30702322 View in PubMed
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Exploration and support in psychotherapeutic environments for psychotic patients.

https://arctichealth.org/en/permalink/ahliterature223527
Source
Acta Psychiatr Scand. 1992 Jul;86(1):12-22
Publication Type
Article
Date
Jul-1992
Author
A. Werbart
Author Affiliation
Psychosocial Research Unit, Nacka, Sweden.
Source
Acta Psychiatr Scand. 1992 Jul;86(1):12-22
Date
Jul-1992
Language
English
Publication Type
Article
Keywords
Data Collection
Environment
Female
Hospital Units - classification - organization & administration
Hospitals, Psychiatric
Humans
Male
Professional-Patient Relations
Psychotherapy
Psychotic Disorders - therapy
Sweden
Abstract
Clinical experience and previous investigations suggest that insight-oriented milieu therapy with psychotic patients presupposes a specific balance of explorative and supportive factors in the milieu. Explorative and supportive factors were translated here to two optimal ward atmosphere profiles using the subscales in the Community-oriented Programs Environment Scale (COPES) as profile variables. Three Swedish therapeutic communities for psychotic patients were then studied by means of COPES. The study showed distinct patterns in these units regarding deviations from the optimal profiles, differences in the balance between the explorative and supportive factors, divergences between explicit treatment philosophy and the perceived ward atmosphere, and differences between patient and staff perceptions of the ward atmosphere. These patterns followed a continuum from a self-governing, nonhierarchical and nonmedical organization to a hierarchical unit that is an integral part of the medical care organization. The conclusion was that a beneficial psychotherapeutic environment requires consistency in the applied treatment model, including an organization and setting that corresponds to the explicit treatment philosophy, well mirrored in the patients' perceptions.
PubMed ID
1414394 View in PubMed
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[Give your opinion about St. Hans hospital. A study of patient satisfaction in a psychiatric hospital].

https://arctichealth.org/en/permalink/ahliterature234702
Source
Ugeskr Laeger. 1987 Sep 14;149(38):2555-60
Publication Type
Article
Date
Sep-14-1987

Frame disturbances in no-fee psychotherapy.

https://arctichealth.org/en/permalink/ahliterature243622
Source
Int J Psychoanal Psychother. 1982-1983;9:135-46
Publication Type
Article
Author
J. Paris
Source
Int J Psychoanal Psychother. 1982-1983;9:135-46
Language
English
Publication Type
Article
Keywords
Adult
Canada
Fees and Charges
Humans
Insurance, Psychiatric
Male
Patient Discharge
Patient Dropouts - psychology
Professional-Patient Relations
Psychoanalytic Theory
Psychotherapy - economics
Abstract
The frame of psychotherapy shows both universality and social relativity. Since the intrapsychic world is permeable to social reality, the meaning of insurance in psychotherapy depends on context. Experience with Canadian National Health Insurance suggests that when no-fee psychotherapy in normative, it is absorbed in the frame. There are still trouble spots in the Canadian system, particularly the management of missed sessions. Depending on the needs of the patient, charging for missed sessions can disrupt therapy entirely or be constructive for the treatment.
PubMed ID
7152812 View in PubMed
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Long-term continuation treatment after short-term day treatment of female patients with severe personality disorders: Body awareness group therapy versus psychodynamic group therapy.

https://arctichealth.org/en/permalink/ahliterature97350
Source
Nord J Psychiatry. 2010 Apr;64(2):115-22
Publication Type
Article
Date
Apr-2010
Author
Harald Leirvåg
Geir Pedersen
Sigmund Karterud
Author Affiliation
Dagpost Kolonien, Sørlandet Hospital HF, 4604 Kristiansand, Norway. harald@leirvag.com
Source
Nord J Psychiatry. 2010 Apr;64(2):115-22
Date
Apr-2010
Language
English
Geographic Location
Norway
Publication Type
Article
Keywords
Adult
Awareness
Body Image
Borderline Personality Disorder - diagnosis - psychology - therapy
Child
Child Abuse, Sexual - psychology - therapy
Combined Modality Therapy
Day Care - methods
Female
Follow-Up Studies
Humans
Long-Term Care
Middle Aged
Norway
Patient Dropouts - psychology
Personality Assessment
Personality Disorders - diagnosis - psychology - therapy
Professional-Patient Relations
Psychoanalytic Therapy - methods
Psychotherapy, Brief - methods
Psychotherapy, Group - methods
Abstract
OBJECTIVE: To investigate and compare the treatment effects of psychodynamic group therapy (PGT) and body awareness group therapy (BAGT) as outpatient treatment following day treatment for personality disorders. MATERIALS AND METHODS: Twenty-one female patients given PGT were compared with 29 female patients receiving BAGT. The average length of outpatient therapy was 24 and 25 months, respectively. The patients were assessed trough the quality assurance system of the Norwegian Network of Psychotherapeutic Day Hospitals, including the Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) for diagnostic purposes. Outcome was assessed using the Global Assessment of Functioning (GAF), Symptom Check List 90-R sum score (Global Severity Index, GSI), Circumplex of Interpersonal Problems (CIP), at admission and at discharge from day treatment, and at the end of outpatient group therapy. RESULTS: Patients undertaking BAGT improved significantly on GAF, GSI and CIP, and reported high ratings of satisfaction with therapy and group climate at the end of outpatient treatment. The magnitude of change on GAF and CIP was significantly higher in the BAGT group compared with the PGT patients who displayed only minor changes after outpatient treatment. CONCLUSIONS: BAGT is possibly an effective outpatient continuation therapy for women with severe personality disorders, but because of limitations of this study, these results warrant a larger randomized study.
Notes
RefSource: Nord J Psychiatry. 2010 Apr;64(2):75-7
PubMed ID
20392134 View in PubMed
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51 records – page 1 of 6.